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Background <p>Colorectal cancer (CRC) is the second leading cause of cancer deaths worldwide. In South Asia, demographic shifts, dietary changes, and healthcare disparities are influencing CRC trends. This study evaluated temporal patterns, projected future burden, and examined links between CRC indicators and key risk factors from 1990 to 2023, with forecasts to 2035.</p> Methods <p>Data from the Global Burden of Disease 2023 study were used to analyze age-standardized rates (ASRs) of DALYs, mortality, incidence, and prevalence at global, regional, and country levels. Trends were stratified by age, sex, and socio-demographic index (SDI). Forecasts to 2035 were generated using the ARIMA model. Risk factor contributions to DALYs and deaths were assessed across dietary, metabolic, and behavioral domains.</p> Results <p>Globally, CRC DALYs declined from 364.57 to 287.69 per 100,000 between 1990 and 2023, while prevalence increased (111.15 to 133.78). In South Asia, all metrices increased, DALYs (115.40-144.21), mortality (4.31-5.55), incidence (4.71-7.02) and prevalence (14.74-25.00) rose. Afghanistan, Maldives, Pakistan and Sri Lanka showed the largest increases, with males consistently more affected. Forecasts indicate further increases in all metrices by 2035. Among risk factors of CRC, smoking showed declining trends but metabolic and dietary factors, particularly high body-mass index, high fasting plasma glucose, and unhealthy diets, showed increasing burden trend in South Asia.</p> Conclusions <p>CRC burden in South Asia is increasing, driven by modifiable risks, aging populations, and socio-economic disparities. Despite modest mortality improvement, rising incidence and prevalence may strain healthcare systems. Prevention, early screening, and interventions targeting metabolic risks are critical to reducing future burden.</p>

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The Evolving Burden of Colorectal Cancer in South Asia: A GBD-Based Analysis of Trends, Risk Factors, and Projections to 2035

  • 期刊论文

  • 发表日期：

    2026年3月18日

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  • Muhammad Babar Khawar,
  • Muhammad Faisal Maqbool,
  • Ali Afzal,
  • Hammad Arshad,
  • Humayoun Huma Maqbool,
  • Javeria Malik,
  • Kaleem Maqsood

摘要

Background

Colorectal cancer (CRC) is the second leading cause of cancer deaths worldwide. In South Asia, demographic shifts, dietary changes, and healthcare disparities are influencing CRC trends. This study evaluated temporal patterns, projected future burden, and examined links between CRC indicators and key risk factors from 1990 to 2023, with forecasts to 2035.

Methods

Data from the Global Burden of Disease 2023 study were used to analyze age-standardized rates (ASRs) of DALYs, mortality, incidence, and prevalence at global, regional, and country levels. Trends were stratified by age, sex, and socio-demographic index (SDI). Forecasts to 2035 were generated using the ARIMA model. Risk factor contributions to DALYs and deaths were assessed across dietary, metabolic, and behavioral domains.

Results

Globally, CRC DALYs declined from 364.57 to 287.69 per 100,000 between 1990 and 2023, while prevalence increased (111.15 to 133.78). In South Asia, all metrices increased, DALYs (115.40-144.21), mortality (4.31-5.55), incidence (4.71-7.02) and prevalence (14.74-25.00) rose. Afghanistan, Maldives, Pakistan and Sri Lanka showed the largest increases, with males consistently more affected. Forecasts indicate further increases in all metrices by 2035. Among risk factors of CRC, smoking showed declining trends but metabolic and dietary factors, particularly high body-mass index, high fasting plasma glucose, and unhealthy diets, showed increasing burden trend in South Asia.

Conclusions

CRC burden in South Asia is increasing, driven by modifiable risks, aging populations, and socio-economic disparities. Despite modest mortality improvement, rising incidence and prevalence may strain healthcare systems. Prevention, early screening, and interventions targeting metabolic risks are critical to reducing future burden.